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Biomedical subjects

R T Sataloff

Publications and source records attributed to R T Sataloff.

At least 37 records · Page 2Linked to original sources
PubMed2001

Cost-effectiveness of two types of dysphagia care in head and neck cancer: a preliminary report.

We conducted a prospective, preliminary study to compare the cost-effectiveness of two different instrument-based techniques for diagnosing and managing dysphagia in 30 consecutive hospitalized patients with head and neck cancer. The two techniques are videofluoroscopy via modified barium swallow (MBS) and videoendoscopy via flexible endoscopic evaluation of swallowing with sensory testing (FEESST). Medicare was the primary insurer of all patients. Fifteen of these patients had their dysphagia diagnosed and managed by MBS and the other 15 by FEESST. Cost-effectiveness was assessed by determining the average Medicare reimbursement for each procedure. We found that the mean reimbursements were $451.01 (+/- $50.55) for MBS and $321.23 (+/- $3.01) for FEESST. The mean reimbursement for FEESST was significantly lower than that for MBS (p < 0.0001; Mann-Whitney U test). We conclude that FEESST appears to be more cost-effective than MBS for the inpatient management of dysphagia in patients with head and neck cancer.

Aged↗
PubMed2001

Autoimmune inner ear disease: steroid and cytotoxic drug therapy.

The goal of this study was to assess the effects of immunosuppressive therapy on hearing in patients with presumed autoimmune sensorineural hearing loss (AISNHL) and a Western blot assay positive for a 68 kD inner ear antigen. To achieve this objective, we conducted a retrospective review of 39 such patients who were treated with either a steroid alone or with a steroid followed by a cytotoxic agent. Pure-tone average (PTA) at 500 Hz, 1 kHz, 2 kHz, and 3 kHz, and speech discrimination scores (SDS) were used as objective measures of outcome. At the completion of treatment, 23 of the 39 patients (59.0%) exhibited a positive response to therapy. The steroid-only responders (n = 6) tended to demonstrate a greater improvement in PTA (14.8 vs 4.5 dB), while the cytotoxic-agent responders (n = 17) had a significantly greater improvement in SDS (26.2 vs 6.9%; p < 0.01). We conclude that most patients with AISNHL benefit from immunosuppressive therapy and that cytotoxic medications appear to improve SDS, even in some patients who have not responded to corticosteroid therapy.

Adolescent↗
PubMed2000

Frequency of cochlear enhancement on magnetic resonance imaging in patients with autoimmune sensorineural hearing loss.

OBJECTIVE: To evaluate magnetic resonance imaging (MRI) scans for enhancement of inner ear structures of patients with sensorineural hearing loss and documented antibodies to the 68-kd inner ear antigen. STUDY DESIGN: Retrospective case review with reexamination of MRI scans. SETTING: Outpatient office. PATIENTS: Thirty-five patients with autoimmune sensorineural hearing loss defined by audiograms documenting a sensorineural hearing deficit in one or both ears and the presence of an anti-inner ear antibody (68-kd band) in serum samples who underwent precontrast and postcontrast T1-weighted axial and coronal MRI scans of the inner ear, which were performed concurrently with the hearing loss. INTERVENTIONS: Diagnostic. MAIN OUTCOME MEASURES: Frequency and intensity of cochlear enhancement on MRI scans. RESULTS: One patient demonstrated +2 cochlear enhancement. However, that finding was thought to represent postoperative inflammatory change. CONCLUSION: No correlation was found between the presence of antibodies to inner ear antigen in patients with hearing loss and cochlear enhancement on MRI scans.

Autoantibodies↗
PubMed2000

Dysphonia related to medical therapy.

It is essential for laryngologists, speech and language pathologists, and others caring for professional voice users to be familiar with the potential vocal effects of any substance ingested by a professional voice patient. This article reviews pharmacologic agents that may have laryngeal side effects. Essentially, any ingested substance is suspect as a cause for voice dysfunction. It is also necessary for laryngologists to educate voice professionals about the consequences of drugs on the voice and the potential problems associated with properly prescribed medication.

Humans↗
PubMed2000

Evaluation of professional singers.

Professional voice users present interesting challenges for laryngologists and speech-language pathologists. Many of these patients place olympic demands on their voices and must meet standards of near-perfection to succeed as vocal artists. Through systematic treatment combining the traditional art of medicine with modern technology, the physician should generally be able to care for the premier voice professional. The expertise gained improves the standard of care for all voice patients.

Humans↗
PubMed2000

Phonomicrosurgery III: pre- and postoperative care.

This article discusses the important aspects of pre- and postoperative care for phonomicrosurgical procedures. Making an accurate diagnosis is paramount to any surgical decision, which involves interdisciplinary evaluations by a laryngologist, voice pathologist, singing voice specialist, and other specialists. Patient selection and candidacy for phonomicrosurgery are discussed, including preoperative vocal rehabilitation, compliance, and pre- and postoperative timing issues. Postoperative voice rest issues are covered, and suggestions for postoperative voice rehabilitation are made. Risks of surgery and potential problems following phonomicrosurgery procedures are presented.

Humans↗
PubMed2000

Impairment, disability, and other medical-legal aspects of dysphonia.

As awareness of the importance of the human voice has grown, so too have legal issues surrounding voice dysfunction. Otolaryngologists must be familiar with principles of impairment and disability and with appropriate medical-legal management for voice patients.

Disability Evaluation↗
PubMed2000

Otogenic cerebrospinal fluid rhinorrhea: a new technique for closure of cerebrospinal fluid leak.

OBJECTIVE: To describe a new technique for control of cerebrospinal fluid (CSF) rhinorrhea and to review alternative approaches. STUDY DESIGN: Five cases and literature review. SETTING: Tertiary referral center. PATIENTS: Five case study patients. INTERVENTION: Surgical. MAIN OUTCOME MEASURE: Control of CSF rhinorrhea. RESULTS: CSF rhinorrhea can be controlled through eustachian tube ligation in the nasopharynx, distal to all known pathways through which CSF leaks may occur from the temporal bone into the eustachian tube. CONCLUSION: Transoral eustachian tube ligation appears to be a safe and effective alternative to other techniques for controlling CSF rhinorrhea and should be included in the otologist's repertoire.

Adult↗
PubMed2000

The Towne-Heuer Reading Passage--a reliable aid to the evaluation of voice.

The science of voice evaluation and assessment has profited from technological advancement and objective measurement of voice parameters has become an integral part of the voice examination, however, subjective voice evaluation remains a vital component of any voice examination. The Towne-Heuer Reading Passage was developed in 1970 to provide a reading sample that would facilitate subjective voice evaluation. The reliability of the passage was established using three judges listening to 15 normal Philadelphia speakers and 15 vocal abuse-misuse clients with verified vocal nodules. The frequency of hard glottal attack (HGA) was determined for the two groups and high interjudge and intrajudge correlation was found. A difference in the frequency of HGA was found between the two groups.

Adolescent↗
PubMed2000

The frequency of hard glottal attacks in patients with muscle tension dysphonia, unilateral benign masses and bilateral benign masses.

Hard or abrupt glottal attack (HGA) is one of the vocal behaviors often associated with benign lesion of the vocal folds. This study was designed to determine whether the frequency of HGA was different in hyperfunctional voice patients with and without vocal fold masses. One hundred and forty-seven subjects were studied. All subjects received a complete otolaryngological evaluation including strobovideolaryngoscopy, objective voice measures, and evaluation by a speech-language pathologist. Thirty-two patients were diagnosed with muscle tension dysphonia (19 male, 13 female) without vocal fold masses. Fifty-seven patients were diagnosed with unilateral vocal fold masses (29 male, 28 female), most of which were cysts. Fifty-eight patients were diagnosed with bilateral vocal fold masses (13 male, 45 female). Of the 45 females with bilateral vocal fold masses. 26 had a vocal cyst and reactive nodule and 19 had bilateral vocal fold nodules. The control group was balanced and matched based on sex and on percentage of singers and nonsingers. It consisted of 49 subjects with no vocal fold pathology (20 male, 29 female). The group was composed of professional speakers, singers, and nonprofessional speakers. All voice disordered groups demonstrated higher frequencies of HGA than the control group. Differences were found between the male and female subjects in this study. No differences were found between the various disorders. Differences were also found between the subgroups of bilateral masses, where the bilateral nodules group presented a higher frequency of HGA than the cyst and contralateral reactive nodule.

Adolescent↗
PubMed2000

Paradoxical vocal fold motion: presentation and treatment options.

Paradoxical vocal fold motion is a rare disorder in which adduction of the folds occurs on inspiration. The disorder presents with signs of airway obstruction and often airway distress, so proper diagnosis by the otorhinolaryngologist is critical to subsequent management. We present a retrospective review of 10 patients with the diagnosis of paradoxical vocal fold motion seen over a 6-year period. Eight patients were females, and 6 required an acute airway intervention at presentation; 3 patients eventually underwent tracheotomy for respiratory decompensation. Six patients had a prior diagnosis of asthma, and this was determined to contribute to their respiratory status. Five patients were treated with botulinum toxin and 2 with flexible nasolaryngoscopic biofeedback, which improved the outcome. A review of the literature confirms a female predominance of patients presenting with paradoxical adduction and airway distress, often with a history of asthma and psychopathology. Our experience with botulinum toxin and biofeedback suggests that these procedures are viable treatment options in the management of patients with this disorder.

Adolescent↗
PubMed2000

Granular cell tumors of the larynx.

Granular cell tumor is a rare neoplasm that may involve the larynx. It is almost always benign. Laryngologists should be familiar with this unusual tumor, its implications and appropriate treatment.

Adult↗
PubMed2000

Bilateral laryngoceles in a young trumpet player: case report.

We report the case of a 16-year-old trumpet player who was referred for an otolaryngologic consultation after his band leader noticed that a neck mass would protrude while the boy was playing. X-rays revealed the presence of bilateral laryngoceles, and computed tomography demonstrated bilateral, air-filled outpouchings of the laryngeal saccules during forced expiration. There was no evidence of any other intra-laryngeal or cervical pathology. Surgery was deferred while the laryngoceles remained reducible and asymptomatic, and the boy was cleared to continue playing.

Adolescent↗